[224 Mothers’ remedies]

Symptoms.—­After an incubation period of about one to five days, the invasion is marked either by simple diarrhea with some general ill-feeling and prostration, or by abdominal pains, vomiting and diarrhea.  Mild cases may recover at this time.  In the stage of collapse, there are frequent watery movements resembling rice water, with vomiting, great thirst, abdominal pains and eruptions on the legs.  There is sudden collapse and temperature that is below normal; nearly all secretions are greatly diminished.  In the so-called cases of cholera sicca (dry) death occurs before the diarrhea begins, although a rice water fluid is found in the intestines after death.  After two to twenty-four hours those who have not died may recover or pass into the stage of reaction in which the signs of collapse and purging disappear.  After improvement, with slight rise of temperature at times, there may be a relapse or the patient may have inflammation of some of the viscera (cavity organs) and suppression of the urine with delirium, coma and death.

The prognosis is worse in infancy, old age and debilitated persons, and in cases of rapid collapse, low temperature and great blueness.  Death rate from thirty to eighty per cent.

Treatment.—­Isolate the patient and disinfect all discharges and clothing.

Use boiled water during an epidemic.

For pain, morphine hypodermically, and apply hot applications to the abdomen.

For vomiting.—­Wash out the stomach and give cocaine, ice, coffee, brandy or water by the mouth.  Intestines may be irrigated with a two per cent solution of tannic acid.

During collapse.—­Hypodermic of camphor, hot applications to the body.  Good nursing and careful diet.

Yellow fever.—­Yellow fever is an acute infectious disease characterized by jaundice, hemorrhages, albuminuria (albumin in the urine).

Cause.—­It is common in the West Indies and epidemic in nearby countries.  It is most common in crowded, dirty, poorly drained portions of sea coast cities.  It is probably caused by a specific organism which is conveyed from one person to another by mosquitoes and not in clothing, as formerly believed.  One attack usually confers immunity.

Symptoms.—­Incubation is about three to four days.  There may be a fore-warning period, but the attack is usually sudden, with chills, headache, backache, rise in fever, and general feverish symptoms, vomiting, and constipation.  Early in this disease the face is flushed, while the conjunctiva and the mucous membrane lining the eyelids is congested and slightly jaundiced.  Fever is 102 or 103 degrees, and falls gradually after one to three days.  Pulse is slow, and while the temperature rises, it again falls.  The stage of calm follows the fall of the temperature with increased jaundice and vomiting of dark altered blood, the “black vomit.”  Hemorrhages may also occur into the skin or mucous membranes.  Brain symptoms are sometimes severe.  Convalescence is usually gradual.  The disease varies from great mildness to extreme malignancy.  Mortality from fifteen to eighty-five per cent.